Area of Preventive Medicine and Public Health, University Rey Juan Carlos, Madrid, Spain.
BMC Public Health. 2009 Dec 14;9:462. doi: 10.1186/1471-2458-9-462.
Maternal health is one of the major worldwide health challenges. Currently, the unacceptably high levels of maternal mortality are a common subject in global health and development discussions. Although some countries have made remarkable progress, half of the maternal deaths in the world still take place in Sub-Saharan Africa where little or no progress has been made. There is no single simple, straightforward intervention that will significantly decrease maternal mortality alone; however, there is a consensus on the importance of a strong health system, skilled delivery attendants, and women's rights for maternal health. Our objective was to describe and determine different factors associated with the maternal mortality ratio in Sub-Saharan countries.
An ecological multi-group study compared variables between many countries in Sub-Saharan Africa using data collected between 1997 and 2006. The dependent variable was the maternal mortality ratio, and Health care system-related, educational and economic indicators were the independent variables. Information sources included the WHO, World Bank, UNICEF and UNDP.
Maternal mortality ratio values in Sub-Saharan Africa were demonstrated to be high and vary enormously among countries. A relationship between the maternal mortality ratio and some educational, sanitary and economic factors was observed. There was an inverse and significant correlation of the maternal mortality ratio with prenatal care coverage, births assisted by skilled health personnel, access to an improved water source, adult literacy rate, primary female enrolment rate, education index, the Gross National Income per capita and the per-capita government expenditure on health.
Education and an effective and efficient health system, especially during pregnancy and delivery, are strongly related to maternal death. Also, macro-economic factors are related and could be influencing the others.
孕产妇健康是全球主要健康挑战之一。目前，孕产妇死亡率居高不下，这是全球卫生和发展讨论中的一个常见议题。尽管一些国家取得了显著进展，但全球一半的孕产妇死亡仍发生在撒哈拉以南非洲地区，这些地区几乎没有取得任何进展。没有单一的简单直接的干预措施可以单独显著降低孕产妇死亡率；然而，人们普遍认为，一个强大的卫生系统、熟练的分娩护理人员和妇女的权利对于孕产妇健康非常重要。我们的目的是描述和确定与撒哈拉以南非洲国家孕产妇死亡率相关的不同因素。
一项生态多群组研究使用 1997 年至 2006 年期间收集的数据，比较了撒哈拉以南非洲许多国家之间的变量。因变量是孕产妇死亡率，与卫生保健系统相关的、教育和经济指标是自变量。信息来源包括世卫组织、世界银行、儿基会和开发署。
撒哈拉以南非洲的孕产妇死亡率值很高，且各国之间差异巨大。观察到孕产妇死亡率与一些教育、卫生和经济因素之间存在关联。孕产妇死亡率与产前保健覆盖率、熟练卫生人员协助分娩、获得改善水源、成人识字率、小学女生入学率、教育指数、人均国民总收入和人均政府卫生支出呈负相关且具有显著相关性。
教育和有效的卫生系统，特别是在怀孕和分娩期间，与产妇死亡密切相关。此外，宏观经济因素也与之相关，并可能对其他因素产生影响。
